Indigenous and Northern Affairs Committee on Oct. 26th, 2016

[The Chair, Liberal, Andy Fillmore]

Welcome, everyone, to the House of Commons Standing Committee on Indigenous and Northern Affairs. Today we're continuing our study of suicide among indigenous peoples and communities. We have a single panel today from 3:30 p.m. to 4:30 p.m.

Thank you very much, panel members, for joining us. We have with us, from Weeneebayko Area Health Authority, Mr. Leo Ashamock, chairman, and Deborah Hill, vice-president of clinical services and chief nursing executive. From the Cree Board of Health and Social Services of James Bay, we have Greta Visitor, assistant executive director. Welcome to you all.

We are happy to give the Weeneebayko Area Health Authority 10 minutes to speak to us, and then we'll go right to the Cree Board of Health for an additional 10 minutes. I'll just mention that, when we get to about nine minutes of those 10 minutes, I'll hold up a yellow card and ask you to move to your conclusion. The red card means we're out of time and need to move to the next speaker or the questions. After the speaking, we'll go into rounds of questions from the members.

There's one other thing. We are very pleased to offer Cree interpretation today. Mr. Greg Spence is with us for the afternoon, if anyone would like the Cree interpretation.

Thanks for that.

Without further ado, I'm happy to give Mr. Ashamock and Ms. Hill the floor for 10 minutes. Thank you.

[Deborah Hill, Vice-President of Clinical Services and Chief Nursing Executive, Weeneebayko Area Health Authority]

I'm going to start briefly. We circulated a document prior to our arrival, and I really don't want to take up our 10 minutes reiterating the document. There are two themes. One is about being a health care provider in the region and the challenges related to that with housing infrastructure, recruitment, retention, and working in an isolated region. The other piece is very near and dear to our chairman's heart. That's the community piece, managing living with the lack of social determinants of health and just the basic conditions in the isolated colonized-type environment.

I'll hand it over to Chairman Loone so he can give you his account from a personal perspective, in a first nations way. He's going to speak in his mother tongue and I am very happy to spend the question and answer period talking about the details and components of the report.

[Leo Ashamock, Loone) (Chairman, Weeneebayko Area Health Authority]

Meegwetch. Thank you.

Good afternoon, ladies and gentlemen.

As you heard, my name is Leo Ashamock. Ashamock in Cree, means loon, the bird. I'm proud to have that name.

I'm a little bit nervous. This is the first time I've ever been in a setting like this, but I'll be okay.

I'll go right to what I've experienced myself and share that with you, to give a picture of the struggle I've had over the years. I'm going to be 65 in February of next year. I'm getting to my retirement. I've worked in the social field for quite some time. I've been a social counsellor in the community mental health program, and now with the Weeneebayko health services, where I come from in Fort Albany, Ontario.

I'm an Indian residential school survivor. From the time I was six years old, I spent seven years in St. Anne's Residential School, which you've probably heard about through the news. It was quite a horrific experience we all had in that school, with what came out of it. The perpetrators have all been dealt with through the courts and the settlement that was handed out.

The formative years that I had...just to share a bit of that, both my mom and dad went through a residential school themselves. They were impacted by their confinement to an institution. They suffered the losses that they had when they were separated from their own parents.

During those years, and then trying to raise a family with us, as siblings, we went through the same thing. We were broken. We were taken away from our home environment and really treated harshly in the environment of being in a residential school. That had its effects. There was no bonding. Nothing happened during those formative years when we really needed to have that close bonding with our parents, since we were torn away at such a tender age of six years old. That really impacted my upbringing also, as I went into my formative years, and then as a young adult and going through high school.

I did very well in school. I was always almost at the top of my class. But when I went to leave the residential school setting, it kind of was a release for me. I went and did what I had to do, without giving a second thought about trying to finish my education. I dropped out of school when I had the chance to at 16 years old. I was in grade 9 for three years, trying to pass my grade 9, which I never did. That was because I was already into alcohol and all that. That didn't go very well later, developing into my teenage years. I did a lot of crazy things, and the abuse of alcohol was a big part of it.

When I started to think about wanting to attach to somebody, my wife and I didn't get along, so I was very abusive. I was drinking away and drinking everything. That didn't help my situation at home at all, at my house, where I physically abused my children and my wife too. That's when it carried on to my wife and I being separated, and being separated from my own children.

When my son was 21 years old, he committed suicide. He killed himself. He shot himself with a 12-gauge shotgun. That's when I was told. One of the parents came up to me and said, “It's your fault, Leo. You did that to him.” I didn't believe that. I couldn't take that. It was too hard for me to accept. I tried to deny it. I tried my best, knowing damn well that it was partly my fault. The reason, I was told, was that my late son used to cry when he'd go to bed at night and say, “I wish my parents were together. Dad's not here. Mom's not here some of the time because she's out drinking.” That caused that, my son committing suicide.

Now I have learned better. I've helped myself. I've gone to treatment for my struggle with alcohol. I've become very different. I tried and worked every position that I could. I was a band manager. I became a council member on my band council. I became a deputy chief. When people were addressing me as chief when I came in earlier, it was kind of a compliment.

I pretty nearly got there, but I got myself in trouble again. I relapsed into being an alcoholic. But since then I have gotten back on track and I'm doing what I need to do and trying to help out in our community. I've been in the social counselling position for about 30 years now, since I've recovered and worked on myself. I try my best to help with the youth in our community.

I'll continue as quickly as I can.

I'm trying to get some help for the youth in our community. We have a lot of suicides. We had a completed suicide last week that we're just laying to rest, a young lad, a 13-year-old boy who committed suicide by hanging himself just last week. At the beginning of this year, we had three completed suicides, one every month in January, February, and March. We had three completed suicides of youth at the beginning of the year. It was very hard for the community. It's quite devastating for the people who have to go through that. I know how they feel. I can attest to that, because I went through that experience myself.

I'm optimistic, though, that things will get better. We're making every effort we can to help the youth that we have. We have to take a look at how we approach that. The focus is mostly on the youth, but it has to be on the nuclear family. The family has to be involved in the work that has to be carried out. That's where we need some help in providing resources to deal with that, dealing with the families. I mentioned it in my presentation. I mentioned the land-based programming that I'm really thinking about, getting the family to go together out in the bush and teaching them how to make a living, of being respectful of creation and mother earth, and the relationship they have with the Creator.

I'll end right there. Hopefully you can read in your document more about what has been outlined, and certainly learn more about what we actually need.

I know we tried to look for some resources for the proposal writing. We need help with that because we don't have the skills developed yet or the personnel to work on those kinds of things. There was a submission we made quite some time ago for a health policy adviser, but it has yet to be materialized and become a reality.

Thank you.

[The Chair, Liberal, Andy Fillmore]

Thank you very much, Mr. Loone. I very much appreciate it.

We're very happy to hear from you, Ms. Visitor, for 10 minutes, and then we'll go into the first round of questions. You have the floor.

[Greta Visitor, Assistant Executive Director, Miyupimaatisiiuun Regional Services, Cree Board of Health and Social Services of James Bay]

[Witness speaks in Cree]

I'll do a quick translation of what I've said: I'm honoured to be here to present in front of you and to also acknowledge my relatives in Eeyou Istchee, meaning the Cree territory of Quebec.

Also, to my friend Leo, thank you for sharing.

I'm glad Leo is here with me today, because I felt rather alone and rather afraid, probably, of sharing my personal story. I could read off a bunch of statistics from the documents we provided, but I'll leave that for your perusal.

As Leo shared with you, most of us are impacted by suicide in one way or another. I have had three family members commit suicide. My sister committed suicide through hanging approximately 15 years ago. It leaves a void within the family, within the heart. My 18-year-old niece through marriage committed suicide this summer. She leaves behind a child. My brother-in-law, who I grew up with, who I went to school with—he and I were friends right from childhood—committed suicide this past winter.

I'm really impacted by those suicides. The common thread amongst my family members is probably the drug and alcohol abuse and the sense of apathy that people feel within our communities. The apathy comes from the fact that a lot of these people see no way out.

In my early twenties, I too considered or contemplated suicide. I went to the point of taking some strong narcotics that I had been prescribed because I was suffering from depression. I was living in an abusive relationship. I stayed in that relationship for five years, and then I had another decade to try to break clean of that, because I too am a product of the residential school system.

I was made to feel unimportant, uncared for, and unwanted. I was considered to be the lowest of the low because I wasn't even allowed to speak my mother tongue in that facility. I was separated from my older sister when I entered the system because I had no desire to learn the English language. I suspect that my sister probably suffered some physical abuse for translating for me. From that separation when we were young like that, when we were in the system, that separation followed us into adulthood. It's only been a couple of decades since my sister and I reconciled our differences.

It was early on in our formative years while we were in the system that we were told through the actions of the supervisors or the people in authority who separated us, not to speak our language. Those were the messages given to children. I heard a gentleman a couple of days ago at a meeting where they were talking about addictions. He said from identity to destiny is where we travel, yet all the children who entered those institutions were robbed of their identity.

It's been a long hard road for most people. For our people to come back into balance and to take their rightful place in this society, they have to come back to the basics. They have to re-embrace who they are as first nations people, as Cree people. Reconciliation is more than apologies. Reconciliation is about taking your rightful place in society.

I think of my grandfather as I speak. My grandfather was 102 years old when he passed. He passed two years ago, and he talked always about the sense of autonomy that each and every one of us has. As first nations people, we were stripped of that autonomy because we were considered to be “less than” and our great white father would decide what was best for us, and that the residential schools were the best things for us.

I talked about my brother-in-law, my sister, and my niece. They were all struggling with addictions, and so was I when I contemplated suicide. I really believe the higher power, the Creator, was looking after me.

I don't come here in front of you with a rehearsed speech. I talk to you from here, from the heart, hoping that's where you'll be touched. When I was in my addictions I was operating from up here, from my head, and I was totally out of balance. It has been the Red Road, so to speak, ceremonies that have brought me back into balance.

For our people, we talk also about our land-based programs. In terms of the Grand Council of the Crees, the CNG, we are the first modern-day treaty and we are in a better position financially than our counterparts across the bay because they are governed under the Indian Act. Each of those communities that are governed under the Indian Act live in third world conditions. I appeal to you to help them as much as you can.

Our place is to re-embrace our culture and be proud once again of who we were, and of who we are to become.

I thank you for listening to me. Meegwetch.

[The Chair, Liberal, Andy Fillmore]

Thank you very much, Ms. Visitor and Mr. Loone, for your testimony. I think I can speak for the committee that you have touched us in our hearts. Thank you.

We'll move into the questions. The first seven-minute question is coming from Michael McLeod, please.

[Michael McLeod, Liberal, Northwest Territories, NT]

Thank you for your presentations. It's very difficult to hear some of the tough times that you've gone through. We've been on the issue of suicide for quite a few months now and every time we hear about the challenges that people are facing, it's really hard.

I'm from the Northwest Territories and I lived in a small aboriginal community of 800 people. I also went through a residential school. I went through the issue of languages. I cannot speak any of the aboriginal languages anymore, even though I didn't speak English until I was six years old. I watch every day in my home community, families that are falling apart because of alcohol, because of drugs. I watch as the youth grow to the age where they can find a way to get their hands on booze and they follow that same path. It's becoming a huge issue. It's a crisis situation and it's causing a real sense of despair within our youth, as you've explained. Most of the youth will commit suicide for issues that, for us as adults are fairly small, but for a child or youth, they are huge. For an adult, it's different. It's usually something bigger, harder for them to deal with.

I read your document, both your presentations, and you make some really good recommendations in your documents. I totally agree that we have to start getting our youth to embrace who they are. They have to be proud of being aboriginal and proud of their culture and their history.

When I looked at your document, one of the first things I looked for was roads because your communities are isolated like most of mine are. You talked about housing and housing is a big issue, but you didn't talk about roads. I wanted to ask if you could just explain if that is something you would consider as having a bearing on the issue of suicide, the real feeling of isolation and being separated from the rest of the population. That's my first question.

[Leo Ashamock, Loone]

That's a good point and surely it does something. We, in the northern, isolated communities, would like to have access to points south and have all-season roads. That issue has been brought up from time to time over the years that I've been involved with my first nation, sitting on council. I've been on council for eight years. I know there have been times we came to meetings, committees like this, to talk about having an access road going up our way. That certainly would alleviate some of the living conditions and also the costs of living, like the isolation factor. It would really help.

Running a facility like we do with our hospital services, there are enormous costs of living and in trying to maintain the hospital and the hospital points north of Moose Factory. Moose Factory has our general hospital. It's a really old building because it was a tuberculosis sanitarium at the time that it was built. Now we're starting to talk about the new facility that we would like to have and certainly we would like to see that fast-tracked and maybe Debbie can elaborate on that too. I know that our CEO, Bernie Schmidt, is also here. Certainly that's something that would be part of the easier access because it costs us a lot of money to ship patients down to a referral point. There's none in Moose Factory now so its further south. Imagine the cost of chartering flights to go to referral points in places like Kingston, Toronto, Ottawa, Sudbury, Timmins. But maybe Debbie can elaborate a little on what I just said.

[Deborah Hill]

I do think that's a factor. That has an impact. When we were pulling this together, we really were thinking, as a health authority, about what we're buried under every day in just trying to provide those basics of care. I do know that one barrier to moving our new hospital project forward is the cost of construction. That certainly is affected by isolation and not having a road.

[Michael McLeod, Liberal, Northwest Territories, NT]

I also want to ask about housing. Initially, when we first started the study, I knew within my own riding the challenges we have with housing, especially with low-cost housing or social housing, but I didn't know the impact that lack of housing has on the way people think, the despair.

We were told by several people who presented that if we could fix our housing situation, then we would probably solve 50% to 60% of our social issues. Would you agree with that type of statement?

[Leo Ashamock, Loone]

I would agree with that. Along with the cost of construction for structures like housing, we're on land that's really bogged down in water. The water table is quite high. We need to look at elevating the ground and proper drainage, which we don't have resources for. There also have to be better foundations because of all that.

[The Chair, Liberal, Andy Fillmore]

Thanks. We're out of time there, Michael, I'm afraid.

The next question is from Cathy McLeod, please.

[Cathy McLeod, Conservative, Kamloops—Thompson—Cariboo, BC]

Thank you all for the presentations from the heart that you gave us today about the absolutely horrific challenges you have to deal with far too frequently every day.

I notice that both groups are representing health authorities. If I can beg your forgiveness, do you have total control over the provision of your health services? Do you feel like you have the autonomy to provide services and programs in the way you believe they need to be done? Is it a transfer and then you have authority for the services in your region?

[Leo Ashamock, Loone]

I don't really know how to respond to that.

The envelope system that the government implements on the amount of money that's being disbursed for the provision of services is limited to a certain amount. That's the issue we are contemplating. There should be a consideration for an increase in our base funding for the services that are identified in the document we completed on the evaluation of our facility and the evaluation of the services we have there. That's already been submitted to the government. We have to move forward on that because we're looking at running a deficit, which we're trying to deal with, of $24 million. That was identified by the evaluation and the audit. It was deemed that we were short-funded for the services we provide, because they are essential services. We have to work with the numbers we have, but we're above that. That's what happened there.

We have a timeline we're looking to meet to be able to carry on the work at Weeneebayko that needs to be done. There are escalating numbers of people who are getting sick. The numbers are not getting any lower. They're only getting higher and higher, as the statistics will probably show in the document that's just been provided.

Deb and Greta can elaborate further.

[Deborah Hill]

I think part of the answer to your question might be that there are different funding models. Parts are funded by the province and the feds to the health authority, and then there is a whole other part of funding that's funded to the first nations bands individually. It is fairly siloed and fractioned, so it's difficult to say we are the health authority. We do not have control over all the health envelopes.

[Cathy McLeod, Conservative, Kamloops—Thompson—Cariboo, BC]

Some communities in Canada have no autonomy. They're still under the federal government in how the funding and the staff are provided. For many years you've had more autonomy in how you deliver your health care services.

[Greta Visitor]

The Quebec Cree, the James Bay and Northern Quebec Agreement, JBNQA, beneficiaries, do get provincial and federal funding. We have guidelines and stipulations that need to be followed for the funds that come into our communities.

You asked about whether or not we have autonomy. We have to adhere to those stipulations. Those of us who work in executive positions or as chairpersons have the challenge of trying to work with a program that is confined or has certain parameters of operation. You try to fit that into a holistic way of thinking.

I visited a facility earlier this month and the challenge was like trying to fit a square into a circle. That was their philosophy, that you fit the square into the circle.

[Cathy McLeod, Conservative, Kamloops—Thompson—Cariboo, BC]

Part of your funding that was coming into your communities or to your organizations to support suicide prevention activities would be a square into a circle. You wouldn't be able to perhaps do something that you believe would work best. You would have to do a mandated program. Is that accurate?

[Greta Visitor]

That's it exactly.

[Cathy McLeod, Conservative, Kamloops—Thompson—Cariboo, BC]

Quickly, do all the communities you service have quality broadband for telehealth and support?

[Deborah Hill]

Yes, we have mobile in all our communities.

We have struggles with infrastructure primarily in Kashechewan. It seems to be offline more than it's online but we do have it.

[Greta Visitor]

All our communities are linked but our broadband is not big enough for the community of Waskaganish or Whapmagoostui, which is so far north that they too have isolation issues.

We do have telehealth in some of our communities.

[Cathy McLeod, Conservative, Kamloops—Thompson—Cariboo, BC]

I think I'm out of time. Thanks.

[The Chair, Liberal, Andy Fillmore]

The next question is from Charlie Angus, please.

[Charlie Angus, NDP, Timmins—James Bay, ON]

I want to thank you for your presentations and for speaking from the heart. I think of Garrett Tomagatick, 13 years old, who was lost. We lost three others in Fort Albany. We lost one in Moose Factory; we lost little Sheridan, plus 700 suicide attempts in Mushkegowuk since 2009. I hear it being called a tragedy. A tragedy is a kid being hit by a car. There is something bigger here.

I came to Moose Factory in 2009 in the middle of the suicide crisis, and it was like walking into a war zone, with the trauma of the front-line workers who were handling this night after night.

I want to thank Weeneebayko for your work. I know I probably give you a lot of grief. I'm phoning you all the time but in my office we're only dealing with a small percentage of what you deal with on a daily basis.

I'd like you to talk about the fact that we're scrambling all the time to get treatment, to get a place to put a young person to get counselling. It's not normal that an MP's office has to phone and threaten a care facility to get treatment for a 13-year-old but we have them coming into emergency wards. You have them flying in and flying out all the time. The need to have a proactive response, because these are wonderful young children.... This is what shocks me, seeing these deaths in Fort Albany. It's such an amazing community.

Could you explain the front-line work to our committee, the lack of resources you have to deal with in getting these young people the treatment they need on a proactive basis rather than on a reactive basis?